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Care Pathway Specialist

Mainstay Medical
Roseland, NJ
  • Expired: over a month ago. Applications are no longer accepted.
Job Description

Mainstay Medical

Mainstay Medical is a medical device company focused on marketing an innovative implantable neurostimulation system, ReActiv8™, for people with disabling chronic mechanical Low Back Pain. The company is headquartered in Dublin, Ireland, with subsidiaries operating in Ireland, the United States, Australia, Germany, and the Netherlands.


 The Role

Mainstay Medical is seeking a detail oriented and compassionate Care Pathway Specialist (Case Manager) who will handle all approvals, follow-up and manage complex issues, and escalations from external support. The successful candidate will be part of a team, collaborating with the Medical Information department, responding to customer inquiries.  Additionally, you will get to be part of a growing team that is on the cutting-edge of innovative medical device technologies. This role is based in West USA and reports to the Business Development Leader.


Position Responsibilities

  • Handles receipt and data entry of all incoming faxes, including patient consents and patient medical records promptly.
  • Provides support and training to the physicians, their office staff patients and family members and triages the call appropriately.
  • Screens patients for Financial Assistance Program eligibility. Clearly documents insurance details, required payments and any additional information to assist patient access and collections.
  • Coordinates with the physician’s office when prior authorization requirements are not in place.
  • Works closely with other departments to ensure that the process is running as smoothly and efficiently, including timely notification of add-ons and cancellations. Ensures the patient access and clinical staff are aware of any potential insurance related delays.
  • Works with Therapy Manager team to determine a plan of action for each patient. Documents each plan of action under the patient’s opportunity in our system and track the progress or completion of each plan of action.
  • Provides limited patient education as it relates to setting expectations with the patient and family members. Explains the process from referral to implant in simple terms and follow standard escalation procedures to turn the patient over to the Therapy Manager team for further education/intervention.
  • Collaborates with field sales to ensure patient barriers are removed or addressed, and internal and external resources are aligned to facilitate the implant process.
  • Upon approval, the Case Manager will assist in referring the patient to the surgeon for consultation, including preparing the necessary paperwork.
  • Actively builds relationships with internal or external customers and able to set realistic expectations.
  • Manages multiple priorities and deadlines successfully and handle stressful situations accordingly. 
  • Ensures compliance with company compliance policy, in particular patient confidentiality (HIPAA) in all Mainstay Medical practices.
  • Performs other duties as required.


Competencies

  1. Teamwork – Able to collaborate with all functions within an organization.
  2. Integrity – Handle confidential information in an effective manner. 
  3. Innovative – Use creativity to problem solve and be agile to adapt to changing business. 
  4. Leadership – Able to lead by example. Establish credibility within the organization and lead others when warranted. 

 

Qualifications

  • Bachelor’s Degree (heath economics, life sciences or public health) preferred. However, will consider an Associate degree for strong candidates.
  • Experience in a medical office or hospital setting with coding and prior authorization experience required. 
  • Knowledge of health insurance industry practices/functions to include Medicare, Medicaid, and all types of commercial and managed care organization’s coverage policies.
  • Maintains a caring, empathetic, and patient-centric approach in all interactions.
  • Skilled at patient engagement and interaction; experience in patient education is a plus. 
  • Demonstrates excellent organizational skills with attention to detail.
  • Clear written and verbal communication skills—both in-person and over the phone. 
  • Proficient in computer operations, including Microsoft Word, Outlook, Excel, PowerPoint, and basic database management.
  • Problem solver and capable to find solutions to challenges or process impediments.


We hope you will join us on this journey to ReActiv8 life! 

* Dr. David Lee gives a quick presentation and perform our implant procedure on a synthetic cadaver. Feel free to watch our segment on Vimeo: https://vimeo.com/647859001/448fb6da23

* Watch video testimonial from Mainstay Medical patients: https://mainstaymedical.com/patients/#testimonials

 

Come join a growing and thriving organization!  We foster an exciting culture founded on teamwork, bias for action, urgency, and accountability, which allow us to develop meaningful and lasting relationships with our colleagues, the Doctors and Patients we serve.

We offer a competitive package.  Our core benefits include: Medical, Dental, Vision, 401(k) Retirement Savings, Life and Short-Term Disability, PTO. 

No Search Agents/Agencies/Recruiters

Position is not available for relocation assistance.

Mainstay Medical

Address

Roseland, NJ
07068 USA

Industry

Healthcare

View all jobs at Mainstay Medical